ENGINEERED INTRAVENOUS THERAPIES FOR TRAUMA.

Area of Science:

• Biomedical Engineering
• Trauma Care
• Pharmacology

Background:

• Trauma-induced hemorrhage and shock are time-critical emergencies, often leading to death within hours.
• Prehospital transport delays, especially in low- to middle-income countries, necessitate effective interventions to control bleeding and manage shock.
• Existing first-generation intravenous hemostats face challenges in clinical translation despite advancements in drug delivery platforms.

Purpose of the Study:

• To review the challenges in translating intravenous hemostat therapies from preclinical to clinical settings.
• To discuss the physiological mechanisms of hemorrhagic shock.
• To introduce and evaluate a novel low volume resuscitant (LVR), PEG-20k, for potential clinical application.

Main Methods:

• Literature review of first-generation hemostats and their translation challenges.
• Physiological overview of hemorrhagic shock.
• Highlighting and discussing the properties of a new low volume resuscitant (LVR) - PEG-20k.

Main Results:

• Few hemostatic therapies have progressed through large-animal preclinical evaluation, and none have reached clinical application.
• Understanding hemorrhagic shock physiology is crucial for developing effective treatments.
• PEG-20k is presented as a promising new low volume resuscitant.

Conclusions:

• Significant hurdles exist in translating advanced hemostatic agents into clinical practice.
• Effective management of hemorrhagic shock requires addressing both bleeding control and volume resuscitation.
• Rational design principles are essential for developing next-generation low volume resuscitants for trauma patients.